Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 12 November (HL2220), what is the timescale for delivery of the proposed reforms to the patient care pathways; what conditions and pathways are in scope for these changes; in what settings this care will be delivered; who will be responsible for ensuring that these changes will be at lower cost; and how will progress be monitored and reported.

As part of the Government's commitment to returning to the 18-week constitutional standard from Referral to Treatment, work is underway and planned throughout 2025/26 to reform patient care pathways to ensure patients are seen in the settings which deliver better patient experience for lower cost.

This pathway reform will look at end-to-end pathways across primary, community and secondary care, and include diagnostics. NHS England is initially prioritising pathways in cardiology, respiratory, ear-nose-throat, gastroenterology and urology due to challenging demand, and is looking at opportunities to improve efficiency across other pathways, including through the use of diagnostic first pathways, integration across settings workforce development. There are ongoing reform efforts underway to address challenges identified in other specialities too. For example, in gynaecology, women’s health hubs are bringing together healthcare professionals and existing services to provide integrated women’s health services in the community to improve health outcomes for women, whilst reducing healthcare inequalities.

NHS England is leading national efforts to support pathway re-design, to take the best of clinically led innovation and practice across the country. Progress will be monitored and reported via the Oversight and Assessment Framework through which trusts report to integrated care boards; these are in turn shared with NHS England regional teams and filter into national reporting.